NC Dental Hygiene Jurisprudence cheat sheet

The NC Dental Practice Act is codified at N.C.G.S. Chapter 90, Article 2 (G.S. 90-22.1 through 90-48.14); the Board's administrative rules appear in Title 21, Chapter 16 of the NC Administrative Code (21 NCAC 16).

The State Board of Dental Examiners consists of licensed dentists, licensed dental hygienists, and public members appointed by the Governor; the hygienist member is a voting member and the Board employs a staff including an executive director and legal counsel.

"Practice of dental hygiene" is defined by statute as the performance of prophylactic, preventive, and therapeutic procedures under the supervision of a licensed dentist, including removal of deposits and stains, polishing, and application of topical agents.

The Board may adopt rules, hold hearings, issue licenses, and discipline licensees; it does not set fee schedules and cannot expand the statutory scope of practice by rule.

A licensed dentist who employs or supervises hygienists is responsible for the acts of those hygienists within the employment relationship and must ensure a written or documented supervision arrangement exists.

Statutory definitions distinguish "supervision," "direct access," "public health setting," and "collaborative practice" - each term carries specific conditions that determine whether a dentist must be physically present.

Emergency and temporary provisions (such as temporary licenses and volunteer/emergency licensure) exist in statute and Board rule; a temporary license is time-limited and tied to a specified supervising dentist or setting.

The Board's rulemaking must follow the NC Administrative Procedure Act (G.S. Chapter 150B), including notice, public comment, and legislative review before a rule becomes effective.

Dental hygiene licensure requires graduation from a CODA-accredited dental hygiene program, successful completion of a Board-approved clinical and written examination (regional board plus jurisprudence), and a criminal background check.

NC licenses renew annually on a calendar-year basis; the renewal period and late fees are set by Board rule, and practicing on an expired license is a violation subject to discipline.

Continuing education for hygienists is required each renewal cycle; the Board sets the total hour requirement and mandates specific content categories, including a jurisprudence/ethics component and CPR certification at the healthcare-provider level.

CE hours must be earned from Board-recognized providers and documented with certificates retained for audit; self-study and non-approved online courses generally do not count toward the required total.

A licensee must report name and address changes to the Board within the timeframe set by rule; failure to receive a renewal notice does not excuse late renewal.

Reinstatement of a lapsed or revoked license may require payment of fees, completion of additional CE, and, where the Board orders it, re-examination or a refresher program.

License status is public information; employers and the public may verify licensure through the Board's online licensee lookup, and licensees must display or produce their license on request.

A hygienist licensed in another state may obtain licensure by credentials or reciprocity only as authorized by statute and Board rule; there is no automatic endorsement of another state's license.

Dental hygienists may perform only those procedures authorized by statute and Board rule; any procedure not expressly authorized remains the practice of dentistry and cannot be delegated.

Supervision levels: direct supervision requires the dentist to be physically present in the office; indirect and general supervision permit the dentist's prior authorization and availability by phone, with conditions set by rule.

Local anesthesia and nitrous oxide administration by hygienists require additional Board-approved training, current certification, and compliance with the applicable supervision level.

Dental assistants may perform certain reversible procedures (coronal polishing, fluoride, radiographs) only after Board-approved training and under the specified supervision; hygienists may not delegate their own scope to unlicensed personnel.

In public health and certain access-to-care settings, hygienists may practice under a collaborative agreement or a Board-issued permit with a defined protocol, referral, and documentation requirement.

A hygienist must refer a patient to a dentist when findings exceed the hygienist's scope or when the patient's condition requires diagnosis or treatment planning reserved to the dentist.

Recordkeeping, informed consent, and infection control requirements apply to hygienists as they do to dentists; each patient encounter must be documented in the patient record.

Grounds for discipline include unprofessional conduct, practicing outside scope, practicing without a current license, fraud in obtaining a license, impairment, and violation of Board rules or a Board order.

The Board's disciplinary process generally proceeds from complaint intake and investigation through a probable-cause determination, then to a consent order or a contested hearing conducted under the Administrative Procedure Act.

Available sanctions include reprimand, censure, probation with conditions, suspension, revocation, civil penalties, and required remedial education or monitoring.

A licensee must report to the Board within the required time any arrest, criminal conviction, or disciplinary action taken by another licensing jurisdiction; failure to report is itself a separate violation.

Licensees must cooperate with Board investigations, including producing records and appearing for interviews; refusing to cooperate can be treated as unprofessional conduct.

Confidential patient information may be disclosed only as authorized by law or Board rule; HIPAA and state confidentiality requirements apply during investigations.

The Board publishes disciplinary actions, and a licensee may petition for reinstatement after the period specified in the order; the Board retains continuing jurisdiction over probationers.

A licensee may appeal a final Board decision to the superior court under the Administrative Procedure Act; the appeal does not automatically stay the sanction unless ordered.